HIV prevalence has decreased in Uganda since the s, but remains substantial within high-risk groups. Here, we reconstruct the history and spread of HIV subtypes A1 and D in Uganda and explore the transmission dynamics in high-risk populations. Of the sequences from the three Ugandan populations, 60 Phylodynamic and phylogeographic analyses using BEAST indicated that the Ugandan epidemics originated in — for subtype A1 and — for D, in rural south-western Uganda with subsequent spread to Kampala. They also showed extensive interconnection with adjacent countries. The sequence analysis shows both epidemics grew exponentially during the s—s and decreased from , which agrees with HIV prevalence reports in Uganda. Inclusion of sequences from the s indicated the origin of both epidemics was more recent than expected and substantially narrowed the confidence intervals in comparison to previous estimates. We identified three transmission clusters and ten pairs, none of them including patients from different populations, suggesting active transmission within a structured transmission network. Phylogenetic analysis of HIV genetic sequences Volz et al. It is thought that HIV-1 subtypes A1 and D spread into East Africa after and disseminated exponentially during the s, partially due to the interconnectivity between cities in the area Gray et al.
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Young men with HIV were dying in that city by the thousands of unusual opportunistic infections such as pneumocystis pneumonia and rare cancers such as Kaposi sarcoma. Sue Desmond-Hellmann, who was also profoundly influenced by the suffering there; she went on to a successful career in oncology and infectious disease. Her star kept rising. At the biotechnology pioneer Genentech, she was responsible for the development of a plethora of novel cancer drugs including monoclonal antibodies such as trastuzumab, or Herceptin, for breast cancer and rituximab for B-cell malignancies.
While our paths have crossed frequently over the years, it was particularly meaningful recently when we met again — this time in, of all places, Kampala, Uganda. It is a world-class facility with a wonderful staff; and it is a place where the link between infectious diseases and cancer is witnessed daily. Both of us found it humbling and inspiring to observe the great work being done by many young researchers working in challenging situations where so many cancer patients are also infected with HIV.
Kaposi sarcoma often presents as dark or purple lesions on the skin of individuals infected with HIV. It still takes a toll in Uganda, despite a laudable program to provide these drugs to people there living with HIV. She had been under care for HIV and had been taking antiviral drugs. Sadly, despite this medical attention, her cancer had not been diagnosed early and had gone untreated.
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MUWRPs scientists and partners are part of a robust research program focused on cohort development, surveillance, and vaccine studies. The program has expanded its portfolio to research into other communicable diseases of public health importance in Uganda. The new study enrolled 90 participants and about 30 volunteers from the RV trial will receive a boost, or additional injection, of the cAd3-EBO vaccine to explore the more long-lasting effect of the vaccination.
Results show that survivors experienced negative health effects that persisted more than two years after the outbreak claimed 39 lives. MUWRP expanded its portfolio to include active surveillance of influenza and influenza-like viruses in humans, animals, and migratory birds in Uganda. The program developed an infrastructure and built capacity in clinical and immunological laboratory testing, data management, conducting clinical trials, and other related activities.
Additionally, MUWRP has renovated a laboratory at Bombo Military Hospital to enhance antimicrobial resistance work also under the GEIS program and enhance mil to mil operations, therefore providing additional diagnostic capabilities for clinicians and additional skills for the lab personnel.
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